Background

Recent studies have indicated that nearly two-thirds of all Americans are considered obese or overweight. While obesity is widely prevalent in populations of varying socioeconomic statuses (SES) and races, it disproportionately affects individuals of Black and Latino backgrounds at rates of 48.1% and 42.5% respectively. Bariatric surgery is utilized in less than 1% of qualified individuals. The rate of individuals of lower SES, Black, and Latino background undergoing bariatric surgery is lower than their white counterparts. We aim to examine key motivators and barriers to completion.

Methods

A retrospective analysis from January 2014-May 2022 was conducted to identify 40 eligible participants. In depth one-on-one semi-structured interviews were completed about the bariatric surgical process. Subthemes were compared across the domains to identify patterns in data and are grouped into global themes, representing the most important factors.

Results

65% identified as Black, 5% Hispanic, and 2.5% as Asian Pacific Islander. Respondents cited prolonged program length, schedule conflicts with program stakeholders such as dieticians, and finding another doctor who did not require bariatric surgery as a prerequisite for other surgeries as reasons for attrition. Additionally, respondents endorsed frustration and confusion with a common feeling of not understanding why they needed bariatric surgery.

Conclusions

Clinicians, dieticians, and referring providers play an important role in the completion of bariatric surgery. Environmental factors and resources were predominant in themes of attrition. Additionally, insurance driven program lengths serve as significant barriers to completion.